If you couldn’t feel the pain, would you be willing to break a bone in your body or drive a nail into your foot for the sake of winning the Olympics? One British researcher, in an interview with the BBC, postulated that up to 30 percent of spinal cord injury (SCI) athletes were boosting. That is, they were self-harming in order to induce autonomic dysreflexia—a potentially life-threatening condition that results in elevated blood pressure and heart rate, which is known to enhance performance. 

In the official 2008 International Paralympic Committee (IPC) study on boosting, almost 17 percent of athletes self-reported that they had used the method to improve performance, even though they were aware of the risks.

In the official 2008 International Paralympic Committee (IPC) study on boosting, almost 17 percent of athletes self-reported that they had used the method to improve performance, even though they were aware of the risks. Fifty percent of those surveyed cited boosting as “dangerous” or “very dangerous.” Boosting can cause blood vessels to burst, and there is a high risk of having a stroke. Why are so many SCI athletes willing to do it?

Typically, cheating involves four motivating factors: money, prestige, lack of choice (perceived or real), and pressure from authority figures. Whatever the reason, people won’t cheat if there’s nothing at stake. 

You can track the growth of doping in the Paralympic Games right along with the growth in the importance and prominence of the event. But a whole new problem came to the forefront in 2000 when the entire Spanish wheelchair basketball team lied about having an intellectual disability. Not one player was actually qualified according to the rules of their supposed classification.

The Paralympic classification system—which sorts athletes into competitive categories based on their disabilities and functions in sport—creates a lot of opportunity for cheating. As the money flows into the Paralympic Games, and as the media shows more interest, the rewards for cheating are suddenly abundant.

 These are the unanswered questions raging around the Paralympic Games after Rio: Is the classification system deeply flawed, or is cheating rampant among Paralympians? Peter van de Vleit, the international chief of Paralympic classification put it to media like this the other week: how many athletes are “inherently pushing the boundaries” of the classification system? How many athletes are just plain cheating in classification? How do you identify that kind of cheating? 

If someone leans on crutches during classification, but traipses around the Village without them—is that it? Can classification allow for participation by athletes with diseases like multiple sclerosis (MS), where symptoms can be minimized by drugs? What’s to prevent those athletes from messing with their drug cocktail to show impairment for classification, but not during races? These are just two hypothetical examples of how the system is imperfect and perhaps manipulated by motivated athletes. 

Even if the classification rules were perfectly written (many argue they are deeply flawed), there’s an inherent problem: the rules are an attempt to draw clear lines, to label and categorize the endless variants of the human body. 

Classification, even at its very best, will always be making categories of “most alike” athletes.  

No two people are exactly alike in their disability and sport-specific function, even when they have the same medical diagnosis. Classification, even at its very best, will always be making categories of “most alike” athletes. And, no matter where the lines are drawn they will (and do) affect athletes’ medal-potential. 

Paralympians have been fighting for financial support and media coverage equal to that of the Olympians. As we get our wish and the rewards continue to grow, so does the incentive to cheat an imperfect classification system. The system will keep changing - it must. But ultimately, whenever and however new classification rules are written, it will still be the responsibility of athletes, coaches, and national team managers to maintain the integrity of Paralympic Games.